Archived: Burford House Nursing Home

Burford House is registered to provide accommodation for up to 30 older people who require nursing and or personal care. There were 26 people using the service on the day of this inspection.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People felt safe living at Burford House. Staff understood how to keep people safe and risks to people's safety and well-being were identified and managed. The home was calm and people's needs were met in a timely manner by sufficient numbers of skilled and experienced staff. The provider operated robust recruitment processes which helped to ensure that staff employed to provide care and support for people were fit to do so. People's medicines were managed safely.

Staff received regular one to one supervision from a member of the management team which made them feel supported and valued. People received support they needed to eat and drink sufficient quantities and their health needs were well catered for with appropriate referrals made to external health professionals when needed.

People and their relatives complimented the staff team for being kind and caring. Staff were knowledgeable about individuals' care and support needs and preferences and people had been involved in the planning of their care where they were able. Visitors to the home were encouraged at any time of the day.

The provider had arrangements to receive feedback from people who used the service, their relatives, external stakeholders and staff members about the services provided. People were confident to raise anything that concerned them with staff or management and were satisfied that they would be listened to.

There was an open and respectful culture in the home and relatives and staff were comfortable to speak with the registered manager if they had a concern. The provider had arrangements to regularly monitor health and safety and the quality of the care and support provided for people who used the service.

We undertook this unannounced focused inspection on the 12 May 2016 to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Burford House on our website at www.cqc.org.uk”

Burford House Nursing Home provides accommodation and personal care for up to 30 older people, some of who live with dementia. There were 25 people living at the service on the day of our inspection.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People received care that met their needs and where possible were involved in planning their care. Care plans and risk assessments were current and provided up to date information and guidance for staff.

People were supported by staff who had been recruited through a robust recruitment procedure. There were sufficient numbers of staff employed at all times to keep people safe.

There were systems and processes in place to monitor the quality of the service. An action plan was in place to address shortfalls identified at the previous inspection. We found that most of the required improvements had been made. However we noted that records were not always updated in a timely or consistent way and this required improvement.

We observed that parts of the building, in particular communal areas and corridors the paint on skirting boards and doorways was very chipped and poorly maintained. Carpets and upholstery was soiled in places. We spoke to the registered manager about the environment which was not pleasant for people who lived at the home. The registered manager told us that a redecoration programme was planned and was due to commence in June 2016.

Burford House Nursing Home provides accommodation and personal care for up to 30 older people, some of who live with dementia. There were 26 people living at the service on the day of our inspection. There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

At the last inspection on 8 November 2013, the service was found to be meeting the standards. At this inspection we found issues in relation to the management of medicines and the use of some equipment which may result in people being unlawfully restrained and increased the risk of entrapment due to insufficient risk management plans and assessment.

The Mental Capacity Act (2005) provides a legal framework for making particular decisions on behalf of people who may lack mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. Where they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS).

We checked whether the service was working in line with the principles of the MCA and whether any conditions on authorisations to deprive a person of their liberty were being met. We found that most people living at the service were able to make their own decisions and those who were unable had their capacity assessed. Staff did not always understand their role in relation to DoLS and the manager was providing training to improve this. DoLS applications for people who needed bed rails were pending an outcome.

People told us they received care that met their needs and were involved in planning their care. Care plans were up to date and included guidance for staff. There was access to health and social care professionals and there was health and wellbeing monitoring carried out by staff at the home.

At times staff felt they were too busy to provide person centred care and the care became more task focused. People reported in meetings and surveys that at times they had to wait for support. The manager reviewed staffing levels and they had a recruitment plan in place. Staff were recruited through a robust recruitment procedure and received the appropriate training for their role.

There were systems in place to monitor the quality of the service and the manager had identified areas they were developing such as dignity, DoLS and medicines management. Action plans were developed included timeframes to ensure completion. This was monitored by the provider.

We found that the provider was in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we took at the back of this report.

We found that the provider was meeting the standards we had inspected. People received care and treatment that were safe and appropriate. There were suitable arrangements in place to ensure that people were safeguarded against the risk of abuse. We noted that there was a system for the management and safe administration of medicines. Staff were appropriately supported in relation to their responsibilities and were enabled to deliver care and treatment safely and to an appropriate standard. There was a system for assessing and monitoring of the quality of service.

Another person who used the service told us, "The staff here are awfully kind, they're wonderful, they always get me something if I need it. The food is adequate, It's not quite home cooking but it's pretty good."

People were satisfied that there was plenty of activities if they wanted to get involved.

People told us how their privacy and dignity was respected and that staff always closed the doors when they're helping with personal care. We observed the home to be visibly clean on the day of our visit; all the people appeared to have had their personal care needs met. People's records were detailed and stored securely.

Staff told us how they enjoyed working at the home and felt supported by management.

Overall we found that standards were being met.